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Malignant Neoplasms
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Mark Biro, Vesna Petronic-Rosic
Management: The treatment of melanoma is based on tumor stage. Early diagnosis combined with appropriate surgical therapy is currently the only curative treatment for melanoma. Surgical modalities used for the treatment of melanoma include wide local excision, with or without sentinel lymph node biopsy, and Mohs micrographic surgery. For wide local excision, surgical margins are based on the depth of tumor invasion. If a sentinel lymph node biopsy is recommended, the procedure is completed simultaneously with wide local excision.
Rare Cancer Presentations
Published in Debjani Sahni, Adam Lerner, Bilal Fawaz, Advanced Skin Cancer, 2022
Bilal Fawaz, Heather A. Edwards, Monica Rosales Santillan, Debjani Sahni, Connor O’Boyle, Daniel L. Faden
Given the rarity of this tumor, there are no NCCN guidelines to aid with management. Wide local excision with at least 1 cm margin and tumor clearance is the mainstay of treatment. Nodal dissection and adjuvant radiation should also be considered based on clinicopathologic features, extent of local spread and margin clearance. Mohs micrographic surgery provides superior margin control and may be considered where the surgeon feels comfortable with assessing the tissue pathology. Chemotherapy has shown limited success to date.2
Clinical features of endometriosis
Published in Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh, An Atlas of ENDOMETRIOSIS, 2020
Caroline Overton, Colin Davis, Lindsay McMillan, Robert W Shaw, Charles Koh
The most common surgical scars involved are the umbilicus following laparoscopy, abdominal scars following gynaecological surgery or Caesarean section and the perineum following episiotomy at childbirth. Most women present with a painful palpable lump, usually more symptomatic at the time of menstruation. Occasionally, women can be referred because of cyclical haemorrhage occurring perimenstrually. Medical treatment may control the symptoms over a period of time, but wide local excision is normally necessary (Figures 3.23–3.26).
Oncoplastic Breast Surgery Techniques When Surgery is Essential for the Management of the Idiopatic Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2022
Ahmet Dağ, Akay Edizsoy, Mustafa Berkeşoğlu
Surgical excision is still a viable treatment option; however, wide local excision may be the appropriate choice, which yields better results. However, a large pouch after wide excision can cause infection and can cause cosmetic problems with severe deformity. The OBS technique after wide excision in breast cancer patients has become a technique that is used more frequently to provide acceptable breast shape [9,10]. Although OBS differs in type and approach, the general principle is based on the reestablishment of an acceptable breast shape without leaving any space by sliding the intraglandular flaps prepared by releasing the patient’s own breast tissue from the muscle after the excision of the diseased tissue. Since most of our patients with IGM are young, serious deformities and poor cosmetic results that occur after surgery for a benign disease are not acceptable. Therefore, we have started using OBS techniques in patients requiring surgery. The common feature of OBS techniques used in the patients included in this study was the closure of the pouch with intraglandular flaps.
Penile Sparing Techniques For Penile Cancer
Published in Postgraduate Medicine, 2020
Wide local excision involves complete excision of the tumor with a wide (>5 mm) margin of surrounding skin and can be an option for tumors throughout the length of the penis. However, it should be avoided for tumors in close proximity to the urethra or those that would result in significant penile deformity. Intraoperative frozen sections should be obtained from the deep and surrounding margins. The tissue defect may be closed primarily if there is sufficient penile skin to prevent distortion of the penis. Otherwise, a split-thickness or full-thickness skin graft may be utilized to cover the defect and improve its cosmetic appearance. In appropriately selected patients with small T1 or T2 disease, the local recurrence rate can range from 7.7% to 23% [70–72]. Baumgarten et al. [9] recently reported a higher local recurrence rate of 40% in patients who underwent wide local excision of T2 penile cancer. However, they also found that when stratified by tumor stage, the 5-year local recurrence-free rates were similar across patients undergoing PST, including wide local excision.
Challenges in the management of localized Ewing sarcoma in a developing country
Published in Pediatric Hematology and Oncology, 2020
Sidharth Totadri, Deepak Bansal, K. L. N. Rao, Richa Jain, Akshay Kumar Saxena, Rakesh Kapoor, Ram Samujh, Amita Trehan
Patients were treated on the backbone of a modified Intergroup study INT-0091 protocol.6 Chemotherapy consisted of alternating cycles of VDC (vincristine 1.5 mg/m2, doxorubicin 75 mg/m2, cyclophosphamide 1,200 mg/m2) and IE (ifosfamide 1,800 mg/m2/day × 5 d, etoposide 100 mg/m2/d × 5 d). Chemotherapy was administered every 3 weeks for a total of 48 weeks. Radiological reassessment was planned at 12 weeks, post cycle 4 of chemotherapy, followed by local therapy. Tumors amenable for wide local excision underwent primary surgery. Postoperative radiotherapy was administered if the resection was marginal or intralesional. Tumors in which wide local excision was deemed unlikely by the surgeon were administered primary radiotherapy. Delayed local therapy was defined as local therapy administered beyond 16 weeks.